The Pension & Benefits Committee recently reviewed the maxima corresponding with the extended health and dental benefit provisions and approved the following changes effective January 1st, 2016:
|
Benefit |
Provision |
Previous maxima |
New maxima |
|---|---|---|---|
|
Extended Health |
Paramedical/Hearing Aids |
$635 |
$649 |
|
Private Duty Nursing |
$19,221 |
$19,653 per year |
|
|
Out-of-Pocket Cap |
$121 single / $243 family |
$122 single / $245 family |
|
|
Dental |
Basic Services |
$2,064 |
$2,108 |
|
Major Services |
$3,111 |
$3,178 |
|
|
Orthodontia |
$3,111 |
$3,178 |
In addition, in keeping with the 2 year lag in the dental fee guide used to calculate eligible dental expenses, the 2014 guide will be used to determine eligible expenses commencing January 1, 2016.
What does this mean?
The amount available for reimbursement has increased to the new maxima as outlined above. For example, the coverage for paramedical practitioners (e.g. physiotherapy) has an annual reimbursement maximum of $649, instead of $635 per year.
Out-of-Pocket Cap
Eligible paramedical and prescription drug expenses are shared between the University and employees - 80% reimbursement is provided until the out-of-pocket cap is reached and then 100% reimbursement applies up to the benefit maxima, as outlined in the following table:
| Eligible Extended Health Expenses (per calendar year) | Reimbursement* | |
|---|---|---|
| Employee | University | |
| Up to $610 (single coverage) or $1,225 (family coverage) | 20% | 80% |
| Over $610 (single coverage) or $1,225 (family coverage) | $0 | 100% |